Dokuz Eylül Hospital in Istanbul is treating patients with Covid-19 (Credit: Burak Ütücü )

The pressures of the coronavirus pandemic are leading to a growing number of resignations among doctors in Turkey. 

Unfair distribution of wages and long working hours, the risk of dying from Covid-19 and a perceived lack of government support are all fueling the exodus.

“Health workers are exhausted and drained,” said Dr Alpaslan Türkkan, chair of the regional branch of the Turkish Medical Association (TMA) in Bursa. He said that several dozen health workers had resigned in recent months in the north-western Turkish city. 

Between July and October, according to TMA national chair Şebnem Korur, around 900 medical professionals quit their jobs or took early retirement. 

The phenomenon prompted an academic study by researchers at three Turkish universities, which is due to be published on November 20. One of the report’s authors, Professor Göksel Altınışık Ergur, who is also a board member of the Turkish Thoracic Society, characterised it as an “outbreak” of resignations and said that nurses were also under intense pressure. 

Professor Göksel Altınışık Ergur (Credit: Personal archive)

“Doctors can resign more easily thanks to their higher salaries, but nurses can’t because of money worries,” Ergur said. 

Health workers were celebrated by the public during the early days of the pandemic. In March, as in other countries hit by coronavirus, Turkish citizens showed their appreciation with nightly rounds of public applause. But news of the growing number of resignations has prompted harsh criticism on social media, with comparisons of health workers who leave their jobs to soldiers fleeing battle

“I’d like to appeal to the consciences of those who think this way,” Türkkan said, highlighting difficult working conditions amid the pandemic. “No health workers are running away from their duty, but we’re tired. A hospital doctor [I know] almost fainted from dehydration because they were sweating so much under their protective suit. A nurse I work with can’t go home to look after her baby because an elderly relative lives there too.” 

Bozyaka Training and Research Hospital in Izmir (Credit: Burak Ütücü)

Türkkan said that many doctors who quit public institutions went to work for private medical services where they have better conditions. 

S, a respiratory disease specialist who asked to remain anonymous, worked at a public hospital in Turkey until resigning in July. 

“I’ve been taking antidepressants for months,” S said. “Many of my colleagues struggle with anxiety and depression.” 

Since leaving, “I feel like I’ve been reborn. I’ve slept well. I don’t regret [quitting] one bit,” S concluded.

The fear of contracting Covid-19 also contributed to S’s decision to leave. 

“I have elderly parents who have chronic illnesses. I didn’t want to take the chance. One of my closest colleagues was in the intensive care unit for weeks and nearly died. I was really shaken by that.”

As of this month, 100 health workers in Turkey have died of Covid-19, and 43 of them were doctors. But the health ministry does not class the illness as an occupational disease, which means health workers who contract coronavirus do not qualify for compensation. 

“Doctors and nurses get sick more often than engineers. This must be considered an occupational disease,” Türkkan said. 

Supplementary payments to doctors, announced by Turkey’s health ministry at the start of the pandemic, have also caused discontent. 

“They were so unjust with those payments that I wish they hadn’t given it out,” said Türkkan. “Nurses who personally took care of Covid-19 patients received 66 liras, but we hear that other workers elsewhere received 20,000 liras. Resident doctors received 1,000 liras, but top surgeons received 4,000. This really ate away at us.” 

Some doctors have had their resignations refused. That was the experience of YK, another respiratory disease specialist at a public hospital, who said that this field had come under particular pressure during the pandemic’s peak. 

“Each doctor had 40 to 50 patients. We could take it up to a certain point, but nobody offered any solutions. I quit due to severe exhaustion – I couldn’t stand up straight – but I still had to work for another month.”

According to Professor Oya Itil, deputy chair of the Executive Board of Turkish Thoracic Society – the professional body that represents respiratory disease specialists – the decision to begin easing Turkey’s lockdown on June 1 was premature. According to statistics from the health ministry, 827 patients were admitted to hospital with Covid-19 on June 1, the day that restrictions began to be relaxed. But by June 15, this daily figure had increased to 1,592, prompting criticism from the Turkish Medical Association. 

Professor Oya Itil (Credit: Burak Ütücü)

“[The easing of restrictions] made us lose control of the pandemic. We are in the second peak of the first wave,” Itil said, pointing out that a failure to isolate infected patients had made the situation worse. “This chaos led health workers to quit.” 

Turkey’s government has tried to discourage health workers from leaving their jobs. 

“Let’s make an effort not to disappear during this period,” Fahrettin Koca, the health minister, said on March 23. Between March 28 and June 8, doctors were prohibited from resigning, but once that restriction was lifted the numbers leaving began to grow. As of October 27, resignations were again suspended, along with annual leave.

Some opposition politicians have spoken out in support of doctors who feel compelled to leave their jobs. 

“The government does not make any effort for health workers who serve at the expense of their lives,” said Gamze Akkuş İlgezdi, vice chairman of the Republican People’s Party (CHP). “That’s why our healthcare professionals are obliged to resign.”

Itil told Inside Turkey that the government should introduce new regulations for health workers, including flexible hours and support payments for the families of those who die from the disease. 

“If resignations continue, and the number of health workers decreases, it might bring on a serious crisis,” he said.